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I am not sure there has been a time when I have felt less understood. Today as I sat at Dave’s appointment and heard myself speak and then listened to the responses, I felt as if I were in some parallel universe. I wondered to myself if I hadn’t spoken out loud. Dr. S asked how Dave was doing and my response was “not as well as he would have you believe.” I explained that I had taken a five day trip to Florida and returned to a very changed Dave. I expressed my concerns at his plans to “back away from work” and that he seemed to be putting his life on hold until the next scan results in six weeks. I mentioned that Dave was spending the majority of his time in bed or sitting around the house which was just not Dave. Here are some of the comments that these thoughts elicited –

“You feel like you are waiting for Dave to die.”

WHAT? No, I feel like Dave is waiting to die, and I am trying to get him to engage in life and live.

“My advice to you is to bite your tongue when he doesn’t want to do something. You will only end up frustrated. Instead go out with a friend.”

I can’t sit around and let him check out of life. And I wouldn’t call it frustration, I would call it fear.

At one point, Dave managed to divert the conversation to Jeff and his movies. I sat and watched the conversation and thought “who the f**** cares about Jackass right now?” Needless to say, I am a little frustrated with the mental health care aspect of Dave’s treatment. The reality is that he is not as engaged with his friends, work and life. And while I will not knowingly create more stress in his life, I will not just sit by and watch either. And I call on you his friends, colleagues and family to do your part too. Let’s all keep him engaged and involved in life. I believe strongly that attitude plays a big part in survival. Thank you for including him in events, asking his advice, and inviting him to do things. He will probably say no. A lot. But he might say yes sometimes too.

I knew that I had to accompany Dave to his appointment yesterday. I felt that he needed me to share my perspective as sometimes he downplays what is really going on. Before we went, I made a brief list of what needed to be discussed.

* Depression – signs I am noticing, how to treat, things to watch out for

Usually when we go to appointments, I sit and listen only asking an occasional question. I had to gear myself up to take the lead and contradict Dave if necessary – not my favorite role but it had to be done. Dave’s appointment was with a research nurse. While we were waiting for his labs to be drawn, she started asking him how he was feeling. My ears perked up when she said “Any issues with depression?” Dave said only a little mostly caused by fatigue. I jumped out of my chair so I could get closer to the conversation. I explained to her that I had gone away for five days and when I returned I noticed such a dramatic shift in Dave’s mood that I asked him if depression could be a side effect of the trial medication. Turns out it is. I explained about the list I had printed out from the NIMH website and how Dave related to almost all of the signs and symptoms. She asked Dave if he thought he needed anything to help with it. He said no. At about that point, Dave was called back to do blood work so she said she would talk to us afterwards.

We met up again a little while later. She went through the standard checklist reviewing medications and side effects. When she asked about pain I prodded Dave to talk about his side pain and brought up his reluctance to use the prescribed pain meds. She encouraged him to take something when needed to stay ahead of the pain and reassured him that they are more than okay to use. We discussed his ongoing stomach issues. She wrapped up by saying that after consulting with Dr. S she had called in a prescription for Dave at our pharmacy for an increased dosage of Zoloft. She also told us she had made an appointment with Dr. S for Monday afternoon so we could talk about the chronic pain and the depression with him. I was relieved to hear that they were taking the depression seriously and I felt that she was very much listening to what I was saying. When you are sitting there it is so easy to start doubting yourself. Am I making this a bigger deal than it is? Is he depressed or is he really just tired like he is saying?

We grabbed a quick bite to eat and then headed home. At that point Dave was miserable. You see he had been in pain Wednesday night. So much discomfort that he wasn’t able to sleep. But he didn’t take anything for it. So by the time he took something with his food, it was really severe. He ended up throwing up breakfast, the pain pills and whatever else he had recently ingested. I headed into work once I could see that he was resting comfortably. Last night we talked about the appointment and I reiterated the point made about taking the pain meds when needed. He agreed with me and knew that the vomiting was directly related to the pain. Lesson learned.

I am glad that I went with him. I am glad that I voiced my concerns. And I will definitely be going with him on Monday.

For the second year in a row my parents said to me, “You need a break. Where would you like to go?” And for the second year in a row I said “Somewhere with sun and water.” So Mom and I headed to sunny glorious Florida for five days. There was a lot of this –

Some of this –

Fresh shrimp tacos –

And this dive that satisfied Mom’s craving for peel and eat shrimp (Looks can be deceiving. The food here was great!) –

We spent our time walking and talking and letting the sun settle over us. Well fed and well rested, I thought I would be ready to tackle whatever might be waiting for me at home. But I was wrong. I came home to a lost retainer situation, work, and stress coming from Dave. So that first night, not ready to deal with any of it, I went to bed. Over the next few days as I was catching up, I spent time with my eyes closed trying to recapture that serene feeling that I found at the beach. I am so grateful for my parents who plucked me out of the snow and stress and gave me time to regroup and relax.

I have mentioned that Dave has been inconsistent about work. That has been a big stressor between us lately. I have been trying to dig beneath the surface to figure out the underlying cause. Yesterday before I left for work, I sent him this email hoping that it would remind him of what he loves about his job. (Minnie Vinnie is the bearded dragon he keeps in his office.)

“so i was thinking. i know you usually go to school in the afternoon. i think it would be really amazing if you could go, grab mini vinnie and hit the hallways. i’m sure the students would be thrilled to see you but more importantly is the impactful and vital lesson that you would be imparting that no matter what life throws at you, you keep persevering. that is something i try to teach my students every day. you are a living example and what you would teach them by merely being in the hallway to greet them is more important than anything they will get in any classroom. at the end of the day, you are an educator with an inspirational, valuable lesson to impart.”

I don’t know if my words had much impact on Dave but writing them down did remind me once again of how strong and amazing Dave is.

Since Dave started the clinical trial in December, work has become an issue. With the commute to Baltimore and feeling generally lousy, he missed quite a bit. Luckily the two week winter break occurred so his absence was felt a little less. Yes, there was tumor growth which ended the trial but prior to that was the Sirspheres treatment which radiated many of the previous tumors. So, tumor wise, I don’t think we are much ahead of where we were, if at all. That is not to discount the battle that Dave’s body has been through in the meantime. I know he is tired.

We have come to a crossroads. How is the rest of the school year going to look? I am pushing Dave to set a reasonable schedule for himself (x days a week, x hours a day) and stick to it. That way everyone knows when to expect him, decisions can be made, support can be given and he once again feels like an integral part of the team. If you have a reason to climb out of bed in the morning, you will.

We met 5 couples at the Hopkins retreat over two years ago. 3 of the patients have since died. We suspect the 4th one might have too since no one has heard from him and he wasn’t doing too well when we met him. That leaves Dave and D. D is the guy who has been living with stage IV colon cancer for over ten years. He has been told on several occasions that “this is it”. And he has proved them wrong every time. D still works full time, referees baseball and basketball on the weekends and enjoys time with his family. He has a supportive wife who kicks his butt when he thinks he might want to give up the fight. I believe this is a combination that has led to his longevity. Out of the 4 other people we met, 3 had stopped working entirely, 3 were clearly depressed and resigned to their fate, and 1 had a partner who was unable to support him because she was depressed. I don’t ever want to think ” I wish I had said….” or “I wish I had done….” The time to act is now.

I printed out a checklist from NIMH that I found in an article about depression and cancer. Dave and I went over the list together and identified which might apply to him. We are going to have an open and honest talk with his doctor at the next visit about this. Usually Dave presents a very optimistic “everything is fine” face to the world. I’ve asked him to let that guard down so we can do whatever we need to get him back on his feet. It has been suggested to me by quite a few people that I contact his doctor myself and give him my perspective. I completely understand this idea but find that I can’t do it. To go behind Dave’s back just doesn’t feel right at this moment. That’s not to say that I have totally ruled it out in the future though.

I have asked Dave how he would spend his time if he wasn’t at work. How would be engage his mind? What would he find value and purpose in doing? I asked him if the tables were turned what advise would he give to me (or his sister or his brother). I wish I could crawl inside his head for just a few minutes to figure out what all was going on in there. It is a struggle to know how hard to push. Am I being selfish? Am I pushing him when he shouldn’t be pushed?

His response to missing work is generally, “I called work and everything is fine.” I don’t know if this makes him feel like they don’t need him there or if he feels let off the hook as far as going. I wish when he called/texted/emailed to say he might be in later that instead of saying “Don’t push yourself. Everything is fine.” That someone would say “Great. See you at 10.” or “Great. There are some things that we need to talk to you about.” Being valued and vital is important to all of us. (I totally understand why people say what they do. I would have done the exact same thing before now.)

I don’t know what is going to happen. I know that it makes me anxious. I can’t let my mind wander too far because the possibilities seem overwhelming. I’ll let you know.

xoxo,

Robyn

(Except for the second to last one, Dave identified with everything else on this list to some degree or another.)

Signs and Symptoms of Depression

Ongoing sad, anxious, or empty feelings

Feeling hopeless

Feeling guilty, worthless, or helpless

Feeling irritable or restless

Loss of interest in activities or hobbies once enjoyable, including sex

Feeling tired all the time

Difficulty concentrating, remembering details, or making decisions

Difficulty falling asleep or staying asleep, a condition called insomnia, or sleeping all the time

Overeating or loss of appetite

Thoughts of death and suicide or suicide attempts

Ongoing aches and pains, headaches, cramps, or digestive problems that do not ease with treatment.

Just a quick update on where things are in the Tremaine house. Dave is set to start the new clinical trial tomorrow (fingers crossed). There was a slight delay last week because he had to have a fasting blood sugar under 170. Although he went into the lab several mornings, his numbers were too high. Usually Dave has very good control over his diabetes but chemo messes with that greatly. Or it could have been the pancakes or the ice cream sundaes. (Why is it human nature to not really want something until someone tells you you can’t have it?!)

So, he was finally able to get a good blood sugar reading on Friday. Tomorrow he goes in to finish up paperwork, labs, and then his first treatment which is a pill this time around. After tomorrow things should be relatively simple. A pill a day at home and going in every couple of weeks for labs. Then in about two months a scan to see what is going on. Hopefully this targeted therapy will get in there and kick some cancer butt.

Work for Dave seems to be hit or miss. This week it has pretty much been a miss. Hopefully the side effects from this new treatment will be manageable so he can get into a more consistent routine.

As for me, I am off to Florida with my mom tomorrow. It is supposed to be warm and maybe a little rainy at times too. I’ll take it though. In Reston tomorrow it is going to be a high of 29 degrees with chances of snow Sunday into Monday. I am so looking forward to some sun (hopefully), some rest (definitely), and time with Mom. I won’t have to be stressing about whether Dave is going into work (he will or he won’t), whether Grant’s IBMYP project gets done (it will!) or hopefully anything else. I have stocked the fridge and the pantry and have left a very detailed itinerary of who needs to be where when and what they need with them. Pop Pop will be helping out too. It does take a village.

xoxo,

Robyn

This was my view last year from my lounge chair. Let’s hope for more of the same!!

Growing up we drank our sun tea out of mason jars. I am not sure where this originated, but Mom had (and still has) them available for the beverage of your choice. Dave and I continued this practice at our house. Our kids’ friends think it is hilarious. “I’d like a jar of water, please.”

For whatever reason my favorite one is a quart sized wide mouth jar. It is the only one of its kind at our house. We have pint sized and quart sized but only one of the wide mouthed variety. Everyone knows to look for “widey” if they are getting me a drink. Unfortunately widey isn’t always clean and available for use.